Epidemiological and clinical researches in the borderline domain between psychology and cancer have produced consequent results, despite the large variety of employed approaches and aimed goals: these results permit to define domains where new investigations still appear promising. If randomized prospective controlled trials that test the impact of psychosocial interventions, constitute to our mind a strategy that must not be bypassed, a special attention should be focussed on the following topics: 1) it seems necessary to add to standard goals (survival and quality of life) the evaluation of the impact on immunity and main biological rhythms (circadian and ultradian). Specific questionnaires should be included (pain, sleep, mood, self-esteem, life events...) and others may need to be developed or adapted (sexuality, spirituality, coping with death); 2) among types of psychosocial management, hypnosis and/or learning of self-hypnosis appears to be a modality of choice since some results have already been obtained on immune pathologies and also on cancer. Mixed to an approach of clinical psychology, such a management could arouse behavior changes toward pathology but also promote an improvement of biological rhythms (action on sleep...) and perhaps, by the way, an immune rebound; 3) on a methodological point of view, trials cannot be double-blind. The effort must then concern sample sizes, that were often insufficient in many trials, but also targeted populations: palliative cancer patients with a good performance status seem more relevant for this type of investigation, since psychosocial interventions usually improve quality of life.

Centre Jean-Perrin, centre de lutte contre le cancer, 58, rue Montalembert, BP 392, 63011 Clermont-Ferrand, France.

Asthma is a chronic disease with intermittent acute exacerbations, characterized by obstructed airways, hyper-responsiveness, and sometimes by chronic airway inflammation. Critically reviewing evidence primarily from controlled outcome studies on hypnosis for asthma shows that hypnosis is possibly efficacious for treatment of symptom severity and illness-related behaviors and is efficacious for managing emotional states that exacerbate airway obstruction. Hypnosis is also possibly efficacious for decreasing airway obstruction and stabilizing airway hyper-responsiveness in some individuals, but there is insufficient evidence that hypnosis affects asthma's inflammatory process. Promising research needs to be replicated with larger samples and better designs with careful attention paid to the types of hypnotic suggestions given. The critical issue is not so much whether it is used but how it is used. Future outcome research must address the relative contribution of expectancies, hypnotizability, hypnotic induction, and specific suggestions.

Harvard Medical School, Cambridge, Massachusetts, USA. danbrown1@rcn.com

To highlight the effects of hypnotic focused analgesia (HFA), 20 healthy participants underwent a cold pressor test (CPT) in waking basal conditions (WBC) by keeping the right hand in icy water until tolerable (pain tolerance); subjective pain was quantified by visual scale immediately before extracting the hand from water. The test was then repeated while the participants were under hypnosis and underwent HFA suggestions. Cardiovascular parameters were continuously monitored. Pain tolerance was 121.5+/-96.1 sec in WBC and 411.0+/-186.7 sec during HFA (p < 0.0001), and visual rating score 7.75+/-2.29 and 2.45+/-2.98 (p < 0.0001), respectively. CPT-induced increase of total peripheral resistance was non significant during HFA and +21% (p < 0.01) in WBC. HFA therefore reduced both perception and the reflex cardiovascular consequences of pain as well. This indicates that hypnotic analgesia implies a decrease of sensitivity and/or a block of transmission of painful stimuli, with depression of the nervous reflex arc.

Department of Clinical and Experimental Medicine, University of Padova, Via Giustiniani No. 2, Padova, Italy. edoardo.casiglia@unipd.it

Biological psychiatry favors drug treatment over non-pharmacological intervention and shapes the way clinicians both treat and understand Tourette's Syndrome (TS). However, drug treatments for TS involve side effects and are potentially toxic to the central nervous system. Moreover, current pharmacological treatments are largely ineffective and at best only provide a modest symptom reduction. In this paper, we describe how non-pharmacological treatments such as focused attention can modulate, reduce, or indeed entirely eliminate the symptoms of TS as well as elucidate the underlying neural mechanisms. Showing that the symptoms of TS are susceptible to self-regulatory interventions such as hypnosis, we propose that attentional training could be used to both treat the disorder and better understand it.

Vancouver Coastal Health Research Institute. dramirraz@gmail.com

The 12-member National Institute of Health Technology Assessment Panel on Integration of Behavioral and Relaxation Approaches into the Treatment of Chronic Pain and Insomnia (1996) reviewed outcome studies on hypnosis with cancer pain and concluded that research evidence was strong and that other evidence suggested hypnosis may be effective with some chronic pain, including tension headaches. This paper provides an updated review of the literature on the effectiveness of hypnosis in the treatment of headaches and migraines, concluding that it meets the clinical psychology research criteria for being a well-established and efficacious treatment and is virtually free of the side effects, risks of adverse reactions, and ongoing expense associated with medication treatments.

Hammond DC. University of Utah School of Medicine, Salt Lake City, Utah 84132-2119, USA. D.C.Hammond@utah.edu

The aim of this study was to determine national patterns and correlates of complementary and alternative medicine (CAM) use among adults with diabetes. METHODS: The authors compared CAM use in 2474 adults with and 28,625 adults without diabetes who participated in the most comprehensive national survey on CAM use (2002 National Health Interview Survey). Eight CAM use categories were created, including dietary, herbal, chiropractic, yoga, relaxation, vitamin, prayer, and other (acupuncture, Ayurveda, biofeedback, chelation, energy healing or Reiki therapy, hypnosis, massage, naturopathy, and homeopathy). An overall CAM use category also was created that excluded vitamins and prayer. Patterns of use were compared with chi-square and independent correlates of CAM use with multiple logistic regression controlling for relevant covariates. STATA was used for analysis to account for the complex survey design. RESULTS: Prevalence of overall use of CAM did not differ significantly by diabetes status (47.6 versus 47.9%, p = 0.81). Diabetes was not an independent predictor of overall use of CAM (OR 0.93, 95% confidence interval [CI] 0.83, 1.05). However, persons with diabetes were more likely to use prayer (OR 1.19, 95% CI 1.05, 1.36), but less likely to use herbs (OR 0.86, 95% CI 0.75, 0.99), yoga (OR 0.56, 95% CI 0.43, 0.72), or vitamins (OR 0.82, 95% CI 0.72, 0.93) than people without diabetes after controlling for relevant covariates. Independent correlates of overall use of CAM differed by age, income, employment, comorbidity, and health status between people with and without diabetes. CONCLUSIONS: This study found that there has been a dramatic increase in overall use of CAM in adults with diabetes; diabetes was not an independent predictor of overall use of CAM; and people with diabetes were more likely to use prayer, but less likely to use herbs, yoga, or vitamins compared to persons without diabetes.

Garrow D, Egede LE. Department of Medicine, Division of General Internal Medicine and Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC 29425, USA.

The present paper intends to briefly review the most important concepts of the modern neuropsychology of the frontal lobes, and to relate these findings to the phenomenology usually encountered in hypnosis research and practice. The frontal lobes have been studied very intensively during the last several years and some of the results, including the syndromes described in frontal-lobe lesions and psychiatric patients, demonstrate striking similarity with hypnotic phenomena. Based on these similarities, an alternative neuropsychophysiological definition of hypnosis/suggestion is proposed, viewing hypnosis/suggestion as the process of external manipulation with frontal-lobe functions with consequent effects upon the entire brain potential of the subject.

Muzur A. Department of Family Medicine, School of Medicine, University of Rijeka, Rijeka, Croatia. amirmuzur@yahoo.com

Thirty years ago, the integration of complementary medicine into cancer care almost was dismissed as quackery. Today, a whole range of complementary and alternative medicine (CAM) techniques have been integrated into the management of cancer, which are often of benefit to patients, when conventional treatment is deemed to have failed or caused intolerable side effects. Health care workers need to inquire about the use of CAM in their patients routinely in a sensitive and nonjudgmental way, and may need to advise patients to stop certain therapies. Yet in advanced cancer, a sensible balance needs to be struck between fear about adverse effects and interactions and the importance of making the remaining weeks/days/months as comfortable and enjoyable as possible.

Filshie J, Rubens CN. Royal Marsden Hospital, Downs Road, Sutton, Surrey, SM2 5PT, UK. jacqueline.filshie@binternet.com

The mediator role of response expectancies and the moderator role of hypnotic suggestibility were evaluated in the analogue treatment of pain. Approximately 1,000 participants were assessed for hypnotic suggestibility. Later, as part of a seemingly unrelated experiment, 188 of these individuals were randomly assigned to distraction, cognitive-behavioral package, hypnotic cognitive-behavioral package, hypnotic analgesia suggestion, placebo control, or no-treatment control conditions. Response expectancies partially mediated the effects of treatment on pain. Hypnotic suggestibility moderated treatment and was associated with the relief produced only by the hypnotic interventions. The results suggest that response expectancies are an important mechanism of hypnotic and cognitive-behavioral pain treatments and that hypnotic suggestibility is a trait variable that predicts hypnotic responding across situations, including hypnosis-based pain interventions.

Milling LS, Reardon JM, Carosella GM. Department of Psychology, University of Hartford, Hartford, CT 06117, USA. milling@hartford.edu

There is ample evidence that hypnosis enhances the effectiveness of psychotherapy and produces some astounding effects of its own. In this paper, the effective components and principles of hypnosis and hypnotherapy are analyzed. The "special" hypnotic and hypnotherapeutic effects are linked to the fact that the ecological requirements of therapeutic change are taken into account implicitly and/or explicitly when working with hypnotic trances in a therapeutic setting. The hypnotic situation is described--theoretically and in case examples--as a therapeutic modality that gratifies and aligns the basic emotional needs to feel autonomous, related, competent, and oriented. It is shown how the hypnotic relationship can help promote a sound ecological balance between these needs--a balance that is deemed to be a necessary prerequisite for salutogenesis. Practical implications for planning hypnotherapeutic interventions are discussed.

Mende M. Psychotherapy Center for Hypnosis, Behavior Therapy, and Biofeedback, Salzburg, Austria. mende@hypnose.co.at

The present study closely examines subject response to the arm-rigidity item of the HGSHS:A. Subject behavior, subject self-report, and surface EMG of the biceps and triceps muscles were monitored. Two distinct ways of passing the item were observed and verified by EMG recordings: some subjects (tremblers) exerted muscular effort to bend the arm and kept it rigidly straight. Others (nontremblers) passively kept the arm straight without exerting muscular effort to bend, even though they reported exerting effort to bend their arm. These two behaviorally and physiologically different methods of passing the item support the idea of individual differences in hypnotic responding and suggest that subjects may be using different mental processes to pass the item.

Winkel JD, Younger JW, Tomcik N, Borckardt JJ, Nash MR. Department of Psychology, University of Tennessee, Knoxville, Tennessee 37996, USA. Jwinkel@utk.edu

Neuroscience documents the activity of "mirror neurons" in the human brain as a mechanism whereby we experience empathy and recognize the intentions of others by observing their behavior and automatically matching their brain activity. This neural basis of empathy finds support in research on dysfunctions in the mirror systems of humans with autism and fMRI research on normal subjects designed to assess intentionality, emotions, and complex cognition. Such empathy research now appears to be consistent with the historical and research literature on hypnotic induction, rapport, and many of the classical phenomena of suggestion. A preliminary outline of how mirror neurons may function as a rapport zone mediating between observing consciousness, the gene expression/protein synthesis cycle, and brain plasticity in therapeutic hypnosis and psychosomatic medicine is proposed. Brain plasticity is generalized in the theory, research, and practice of utilizing mirror neurons as an explanatory framework in developing and training new skill sets for facilitating an activity-dependent approach to creative problem solving, mind-body healing, and rehabilitation with therapeutic hypnosis.

Rossi EL, Rossi KL. Ernest@ErnestRossi.com

Theories about dreams have shaped our thinking about mind-body unity and the influence of thought on the body. In this article, the authors review the sparse literature regarding the use of hypnosis with children's dreams and nightmares, summarize how hypnotically induced dreams have been used to resolve psychological symptoms, and note five themes in the literature worthy of further investigation. Building on the value of both dreams and hypnosis for working through conflicts, the authors united mind-body medicine and hypnotically induced dreaming in a pediatric pulmonary practice. A case series is presented of 11 patients who were offered an opportunity to review their reported nightmares through hypnosis in order to uncover their potential meaning. The recurrent nightmares among these patients decreased greatly in frequency or resolved following the hypnosis enhanced dream review. Thus, we demonstrate that hypnotically induced dream review may be useful in a pediatric population.

Linden JH, Bhardwaj A, Anbar RD. jhlinden@cs.com

A prospective controlled trial was conducted to compare the efficacy of an analgesic cream (eutectic mixture of local anesthetics, or EMLA) with a combination of EMLA with hypnosis in the relief of lumbar puncture-induced pain and anxiety in 45 pediatric cancer patients (age 6-16 years). The study also explored whether young patients can be taught and can use hypnosis independently as well as whether the therapeutic benefit depends on hypnotizability. Patients were randomized to 1 of 3 groups: local anesthetic, local anesthetic plus hypnosis, and local anesthetic plus attention. Results confirmed that patients in the local anesthetic plus hypnosis group reported less anticipatory anxiety and less procedure-related pain and anxiety and that they were rated as demonstrating less behavioral distress during the procedure. The level of hypnotizability was significantly associated with the magnitude of treatment benefit, and this benefit was maintained when patients used hypnosis independently.

Liossi C, White P, Hatira P. School of Psychology, University of Southampton, Southampton, United Kingdom. cliossi@soton.ac.uk

This paper clears up some misunderstandings of Woodard's Phenomenological and Perceptual Research Methodology presented by Beshai in a recent critique. Beshai's critique helps demonstrate and validate a number of themes in Woodard's Perceptually Oriented Hypnosis. First, for each of us, our historical learnings provide the basis for scientific progress but at the same time may impede new views and even a more comprehensive understanding of hypnosis. Second, hypnosis is fundamentally a process of differentiating personal meanings that can be vastly different for various individuals. Third, Beshai uses a quantitatively based approach to understanding phenomenon different from Woodard's qualitative research process. Last, holistic understanding of hypnosis is impeded when aspects of the phenomenal field are taken quantitatively out of context.

Woodard FJ. Woodard Hypnosis and Research, Inc, USA. Fredwoodard@aol.com

A thorough investigation of the neural effects of psychotherapy is needed in order to provide a neurobiological foundation for widely used treatment protocols. This paper reviews functional neuroimaging studies on psychotherapy effects and their methodological background, including the development of symptom provocation techniques. Studies of cognitive behavioural therapy (CBT) effects in obsessive-compulsive disorder (OCD) were consistent in showing decreased metabolism in the right caudate nucleus. Cognitive behavioural therapy in phobia resulted in decreased activity in limbic and paralimbic areas. Interestingly, similar effects were observed after successful intervention with selective serotonin reuptake inhibitors (SSRI) in both diseases, indicating commonalities in the biological mechanisms of psycho- and pharmacotherapy. These findings are discussed in the context of current neurobiological models of anxiety disorders. Findings in depression, where both decreases and increases in prefrontal metabolism after treatment and considerable differences between pharmacological and psychological interventions were reported, seem still too heterogeneous to allow for an integrative account, but point to important differences between the mechanisms through which these interventions attain their clinical effects. Further studies with larger patient numbers, use of standardised imaging protocols across studies, and ideally integration with molecular imaging are needed to clarify the remaining contradictions. This effort is worthwhile because functional imaging can then be potentially used to monitor treatment effects and aid in the choice of the optimal therapy. Finally, recent advances in the functional imaging of hypnosis and the application of neurofeedback are evaluated for their potential use in the development of psychotherapy protocols that use the direct modulation of brain activity as a way of improving symptoms.

Linden DE. School of Psychology, University of Wales Bangor, Bangor, UK. d.linden@bangor.ac.uk

A Book Review by Judith E. Pearson, Ph.D., L.P.C.

Have you ever fantasized about being someone else, or wondered who you might be, if you were living at another time and in another place? Do you ever dream that you are living a life other than your own? In The Hypnotic Use of Waking Dreams psychotherapist Paul W. Schenk explores the therapeutic and spiritual implications of imagined alternative lives. Through "waking dreams" Schenk invites his clients to imagine themselves as another person, living another life, as a "dream character." The dream life provides the client's medium for working through current life issues and problems from another perspective.

Schenk hypnotically guides his clients to imagine being the main character in a fictional life---one made up entirely by the client. The client describes significant events in this imagined life and then narrates the dream character's death and after-life experiences. Schenk believes that the true power of the waking dream begins in the after-life episode, a time of philosophical reflection and spiritual exploration.

The author draws from the work of Raymond A. Moody Jr. M.D., who, in the 1970s wrote an astonishing bestseller, Life after Life, in which he documented interviews with people who recounted their near-death-experiences (NDEs). Moody found that NDEs contain common features: awareness of death, feelings of peace, a sense of bodily separation, entering a dark region, seeing or being enveloped in light, encountering spirit entities or deceased loved ones, and a return to the physical body.

Schenk tells his readers that when his clients describe the death of the dream character, they report experiences similar to those of an NDE. Schenk's tenet is that by imagining the after-life experience of an imaginary self, the client can reflect upon the deeper meanings and purposes of his or her own life. He asks, "What did you learn from this life?"

The waking dream is reminiscent of Dorothy's adventure in the Wizard of Oz. Waking dreams serve many purposes for clients:

• Clients discover previously unrecognized faulty assumptions about a problem.
• They can safely try out new solutions in a virtual reality.
• They can develop abilities and relationships they lack.
• They see their problems from another perspective.
• They establish a cue to remind them to carry their insights forward into their real lives.
• They develop insights into the dynamics of their current relationships.
• They use the waking dream to address metaphysical, existential, and spiritual issues.

Schenk asks his clients to dialog with the dream character, to see parallels between the dream life and the client's real life, and to discuss the implications of dream content. He also asks his clients to identify and converse with "spirit guides" representing intuitive parts of the client's own personality.

The book contains several case examples of waking dream work, with transcripts of the client-therapist conversation (often across multiple sessions). These case examples illustrate methods of trance induction, the use of guided imagery, and hypnotic language patterns. Dr. Milton H. Erickson's influence is evident in the use of metaphor, anchoring resourceful states, ambiguity, a permissive approach, open-ended questions, reflective listening, utilization, and client-initiated discovery. Each waking dream unfolds spontaneously as a teaching tale, created by the client. Throughout, the therapist facilitates the process by asking questions, encouraging exploration and curiosity, and suggesting choices and possibilities. Clients choose their own dreamscapes, work through dilemmas in their own way, answer their own questions, find their own meanings and interpretations, and draw their own conclusions.

The case examples include presenting problems such as trauma and grief, forgiveness, belief change, life transitions, phobias, and undesirable personality traits. These examples illustrate what Schenk calls "the overlap between psychotherapy and spirituality." He also reflects on the profound effect that 20 years of this work has had on his own life, reporting that it has led him to examine his thinking on past lives and reincarnation, the existence of spirit guides, one's after-life, out-of-body experiences, and multiple personalities. Indeed, in reading the case transcripts, it is often hard to tell what, in each client's story, is imagined and what might be true "paranormal" phenomena. Or is it the case that all "paranormal" phenomena are simply figments of the imagination and a game played by a creative subconscious?

Hypnotherapists, especially those who work with metaphor and guided imagery, will likely be drawn to working with waking dreams, and will enjoy this book. Like one viewing a Rorschach test, each reader will find something uniquely intriguing about this book, depending on one's model of what constitutes the human personality and mind. Some will find in this book much evidence of the subconscious mind at play. Others will see this work as highly spiritual, giving a glimpse into the latent supernatural abilities in each individual. Some readers will see in this book evidence of various therapeutic approaches and theories of personality, such as psychodynamics, ego state theory, Rogers' client-centered approach, Gestalt Therapy, and of course, Erickson's language patterns.

In The Hypnotic Use of Waking Dreams the line between reality and fantasy becomes slightly blurred, and entices us to ask questions about the mind and soul, about life and after-life. The answers are elusive, but the questions are sheer delight!

______________

Judith E. Pearson, Ph.D. is a licensed mental health counselor, psychotherapist and life coach practicing in Springfield, Virginia. She is Executive Director of the National Board for Certified Clinical Hypnotherapists at www.NatBoard.com. She has recently published The Weight, Hypnotherapy and You Weight Reduction Program: An NLP and Hypnotherapy Practitioner Manual with Crown House. Her website is www.EngageThePower.com

Procedures for estimating hypnotic depth have been used for more than 70 years. This study predicted self-reported hypnotic depth from the phenomenological and behavioral variables of the Phenomenology of Consciousness Inventory-Hypnotic Assessment Procedure (PCI-HAP). Participants were divided into 2 groups; 1 was used to generate regression equations, and the other group was used for cross-validation. Both imagery vividness during hypnosis (imagoic suggestibility) and the PCI pHGS measure of hypnotic depth (hypnoidal state) accounted for most of the variance in self-reported hypnotic depth. The above results, further supported by correlational and 3-D visual analyses, are consistent with other researchers' observations that ratings of hypnotic depth are a function of: (a) alterations in subjective experience, and (b) the perception of responsiveness to suggestions. The findings are also congruent with J. Holroyd's hypothesis that suggestibility and altered-state effects interact to produce hypnotic effects.

Pekala RJ, Kumar VK, Maurer R, Elliott-Carter NC, Moon E. Coatesville Veterans Administration Medical Center, Coatesville, Pennsylvania, USA. Ronald.Pekala@med.va.gov

The hypothesis that water "treated" with intention can affect ice crystals formed from that water was pilot tested under double-blind conditions. A group of approximately 2,000 people in Tokyo focused positive intentions toward water samples located inside an electromagnetically shielded room in California. That group was unaware of similar water samples set aside in a different location as controls. Ice crystals formed from both sets of water samples were blindly identified and photographed by an analyst, and the resulting images were blindly assessed for aesthetic appeal by 100 independent judges. Results indicated that crystals from the treated water were given higher scores for aesthetic appeal than those from the control water (P = .001, one-tailed), lending support to the hypothesis.

Radin D, Hayssen G, Emoto M, Kizu T. Institute of Noetic Sciences, Petaluma, CA 94952, USA. dean@noetic.org

This research explored whether hypnotic suggestion could produce a subjective mindbody condition similar to that produced by the psychoactive drug methylenedioxy methamphetamine (MDMA, Ecstasy). Twelve participants received posthypnotic instructions to re-experience an MDMA-like state posthypnotically, similar to one in their prior experience, for one hour. Three separate self report measures and qualitative self reports showed that the posthypnotic condition effectively mimicked an MDMA-like experience, lasting an hour at a stable level. Participant ratings in real time and in retrospect ranged from 36% to 100% similarity to a drug-induced experience. The qualitative reports and rating scales enabled a phenomenological description of the subjective experience. Scores on the Tellegen Absorption Scale correlated significantly with the strength of the posthypnotic condition (Spearman rho .87, p = .0003). The participants successfully carried out various intentional activities during this time (e.g., self reflection, talking with partners about relationships, artwork, walking in nature). Applications for this technique as an adjunct to therapy and health treatments are discussed.

Hastings A. Institute of Transpersonal Psychology, 1069 East Meadow Circle, Palo Alto, CA 94303-4231, USA.

Silverman in 1983 held that the unconscious encoding of MOMMY AND I ARE ONE triggers a fantasy of symbiotic union with the good mother of early childhood. In contrast, later Sohlberg and Birgegard contended that MOMMY AND I triggers associations to similarity issues with mother, associations that may be influenced by the words following MOMMY AND I. Although their messages produce, lmost invariably, no reportable sensation, Sohlberg and Birgegard claimed strong evidence for the influence of such messages on perception, motivation, and memory, 10 ays poststimulation and suggestive evidence 4 mo. later. Their findings are not compelling evidence for these claims; and there is no evidence that any result was associated with the unconscious encoding of the psychodynamic meaning of a multiword message.

Fudin R. Psychology Department, Long Island University, Brooklyn Campus, Brooklyn, New York 11201, USA. robert.fudin@liu.edu

Using microelectrode recordings of postganglionic sympatheticaction potentials, the authors studied the effects of hypnotic suggestion on sympathetic outflow targeted to skin during static handgrip exercise. All subjects performed sustained handgrip at 33% maximal voluntary contraction (MVC) for 2 minutes during 3 consecutive trials. Two subjects randomly assigned to a hypnosis condition received suggestions that the 2nd trial was more difficult and the last trial was less difficult than the first trial. Two subjects randomly assigned to the control condition received no hypnosis or suggestions about task difficulty. In the nonhypnosis condition, skin sympathetic nerve activity (SNA) increased by 6% from baseline during the 2nd trial and 13% from baseline during the 3rd trial. In the hypnosis condition, skin SNA increased by 25% during the 2nd trial (suggestion of increased difficulty) and returned to baseline during the 3rd condition (suggestion of decreased difficulty). Therefore, the impact of central command on skin SNA is suggested by these results.

Robinson RC, Crasilneck H, Garofalo JP, Whitfill T. Baylor University Medical Center, Dallas, Texas 75246, USA. RichardR@BaylorHealth.edu

Much research indicates that attempts to suppress thoughts lead to increased accessibility of those thoughts, especially when additional cognitive load is present. On the premise that hypnosis may permit more effective management of cognitive load, it was hypothesized that hypnosis may enhance more effective thought suppression. The present research examined whether the obstacle of cognitive load could be bypassed using hypnosis to facilitate successful thought suppression. Thirty-nine high and 40 low hypnotizable participants were hypnotized and received either a suppression instruction or no instruction for a memory of an embarrassing experience and subsequently completed a sentence-unscrambling task that indexed accessibility of embarrassing thoughts. Whereas lows instructed to suppress displayed a delayed increase in suppressed thoughts, highs did not. These findings support the proposition that hypnosis facilitates thought suppression.

Bryant RA, Wimalaweera S. School of Psychology, University of New South Wales, Sydney, Australia. r.bryant@unsw.edu.au

Exploratory factor analysis and psychometric properties of the valencia scale on attitudes and beliefs toward hypnosis. Therapist version. This investigation examines the psychometric properties and factor structure of the Valencia Scale on Attitudes and Beliefs toward Hypnosis-Therapist version. Data from 775 professional psychologists belonging to the Spanish Association of Psychologists were used for the exploratory factor analysis (EFA). Retest included data from 426 participants who answered to the test. The EFA revealed eight factors (Fear, Memory, Help, Control, Collaboration, Interest, Magic and Marginal). Each factor showed good internal consistency and reliability, similar to the client version of this scale. ANOVA indicate that some variables (having scientific knowledge, having received practical information on hypnosis, to use hypnosis, and to show interest in receiving more theoretical and practical information on hypnosis), tend to reduce inadequate beliefs and negative attitudes toward hypnosis. Our results provide the basis for carrying out confirmatory factor analysis and studies of convergent validity on the scale, and of the sensitivity of the scale to change.

Capafons A, Morales C, Espejo B, Cabanas S. Faculty of Psychology, Universidad de Valencia, 46010 Valencia, Spain. antonio.capafons@uv.es

The negative effects of false information presented either prior to (proactive interference; PI) or following (retroactive interference; RI) true information was examined with word definitions (Experiment 1) and trivia facts (Experiment 2). Participants were explicitly aware of which information was true and false when shown, and true-false discrimination was evaluated via multiple-choice tests. Negative suggestion, defined as poorer performance on interference items than noninterference (control) items, consistently occurred when the wrong information followed the correct information (RI) but not when it preceded the correct information (PI). These effects did not change as a function of retention interval (immediate, 1 week, or 3 weeks) or number of incorrect alternatives (1 or 3). Implications of this outcome for experiencing incorrect information in both academic and nonacademic situations are considered.

Brown AS, Brown CM, Mosbacher JL, Dryden WE. Department of Psychology, Dedman College, Southern Methodist University, Dallas, TX 75275, USA. abrown@smu.edu

Between 60 and 90% of patients consult their family doctor for stress-associated complaints. Not infrequently, a considerable number of these patients already have elevated blood pressure. The positive effect on high blood pressure of relaxation techniques has been confirmed in various studies. Accordingly, stress management should now have a permanent place in effective antihypertensive treatment. Appropriate relaxation techniques include, for example, autogenic training, progressive muscle relaxation, visualization and breathing exercises, chi gong and yoga.These practices are incorporated in various lifestyle programs.They act in different ways, and can be offered to the patient in accordance with his/her individual wishes.

Schwickert M, Langhorst J, Paul A, Michalsen A, Dobos GJ. Abt. Innere V Naturheilkunde und Integrative Medizin, Kliniken Essen-Mitte. M.Schwikert@kliniken-essen-mitte.de

The development of episodic memory, its relation to theory of mind (ToM), executive functions (e.g., cognitive inhibition), and to suggestibility was studied. Children (n= 115) between 3 and 6 years of age saw two versions of a video film and were tested for their memory of critical elements of the videos. Results indicated similar developmental trends for all memory measures, ToM, and inhibition, but ToM and inhibition were not associated with any memory measures. Correlations involving source memory was found in relation to specific questions, whereas inhibition and ToM were significantly correlated to resistance to suggestions. A regression analysis showed that age was the main contributor to resistance to suggestions, to correct source monitoring, and to correct responses to specific questions. Inhibition was also a significant main predictor of resistance to suggestive questions, whereas the relative contribution of ToM was wiped out when an extended model was tested.

Melinder A, Endestad T, Magnussen S. University of Oslo, Norway. a.m.d.melinder@psykologi.uio.no

To assess whether perioperative hypnosis can reduce the length of hospitalization and alter the need for postoperative analgesics in patients undergoing the Nuss procedure. Ten consecutive patients (age range, 12-18 years) underwent the Nuss procedure with the same operative technique. For pain management they were divided into two sequential groups: the 5 patients in the nonhypnosis group were managed with an epidural catheter, and analgesia was supplemented with intravenous or oral narcotics as requested. These patients all required Foley catheters for bladder drainage while the epidural was in place. The second group of 5 patients was prepared by teaching them self-hypnosis for postoperative pain management in one or two brief sessions. Postoperative self-hypnosis was prescribed and encouraged. These patients were allowed patient controlled analgesia and were supplemented with intravenous or oral narcotics as requested. Four of the patients in this group required a straight catheterization of the bladder the evening of surgery. Data collected included hospitalization and analgesia requirements as well as other unusual findings.The patients in the hypnosis group spend an average of 2.8 days in the hospital compared with 4.6 days in the nonhypnosis group (p < 0.01). There was also a trend toward less parenteral narcotic use. Postoperative discomfort was better controlled with oral analgesics in the hypnosis group. There were no adverse effects from the hypnosis. In this small study, perioperative hypnosis was associated with a reduced hospital stay in patients undergoing the Nuss procedure for pectus excavatum.

Lobe TE. Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA. Lobet2@ihs.org